Provider Demographics
NPI:1588890081
Name:GASSMAN, STEPHANIE IRENE (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:IRENE
Last Name:GASSMAN
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8406 W BUCKTOOTH RUN RD
Mailing Address - Street 2:
Mailing Address - City:LITTLE VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:14755-9793
Mailing Address - Country:US
Mailing Address - Phone:716-945-1242
Mailing Address - Fax:
Practice Address - Street 1:8406 W BUCKTOOTH RUN RD
Practice Address - Street 2:
Practice Address - City:LITTLE VALLEY
Practice Address - State:NY
Practice Address - Zip Code:14755-9793
Practice Address - Country:US
Practice Address - Phone:716-945-1242
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-10
Last Update Date:2013-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019064235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist